Circlo Podcast

The Path: Marathon to the Operating Room

This is the second article out of four parts of this interview with Dr. César Ramírez.

If you would like to read the introduction to the interview and backstory of Dr. César Ramírez, I suggest you read The Humanist Surgeon: The Boy Who Watched Over His Brother

We shared a thoughtful podcast-style conversation in which he educated me — and will hopefully educate you — on a range of topics.

The purpose of this interview was simple: to grow both personally and technically.

Above is the full video for this section of the interview. The complete interview with all sections is available below.

Complete Interview: The Humanist Surgeon — Dr. César Ramírez

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To guide this interview, I divided our conversation into four sections: Personal Life and Childlike Vision, Vision and Path, Creativity, and Reflections.

In this article, I focus on the Vision and Path section. Circlo stands on the idea of becoming a better human surgeon — someone who connects, empathizes, and understands human needs while having the knowledge to save them. This section highlights his path through medicine, how he viewed surgery when he was younger and what it means now to be one; he represents his way of living medicine.

A very unique story that will educate you in his vision of medicine and his path.

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The Marathon Begins

"The only way to do great work is to love what you do." — Steve Jobs

I began this section by asking about his transformation through surgery. How he observed medicine and surgery when he was a child, perhaps from what he saw in the movies as precise and high-level, and how he sees himself now, entering the operating room. I believe we all have transformations in life. We all have an idea of where we want to get to, even in mundane activities, and often when we get there, we have a new realization. That's called learning from experience.

When he was young, he saw medicine as something incredibly highly placed on a pedestal. This distant aspiration was intensified because his father could not study medicine, which was his aspiration, because the city in which they lived did not offer that career and they did not have resources to travel.

At home, they had a culture of effort, promoted by his parents. This pushed him to always get good grades and have the chance to go and study medicine after high school.

While studying medicine (in Spain, medicine can be studied as an undergraduate degree), he had doubts between specialties, as he was also an athlete. He was particularly interested in traumatology and sports medicine. Over time, he continued to have doubts, but eventually decided on digestive surgery. The reason, he explained, was that “it is a specialty that is very broad in terms of what you have to do and, at the same time, has many different subspecialties.”

Some surgeons focus on the liver, biliary tract, and pancreas; others on the colon and rectum; others on thyroid surgery of the neck; and others on the esophagus and stomach, including obesity surgery. It is a highly subspecialized field. This is interesting and a concept we will discuss in the third article on creativity.

Because this specialty has many different subspecialties, it invites creativity to play a key role—translating techniques, observations, and concepts from one area to another. In addition, its wide variability trains your thinking differently with each operation. Having such operational diversity prevents you from being confined to a single box of habitual thoughts and standard approaches to operating, keeping the door open to innovation and creativity.

When young, he saw this path really, really far. Here is the lesson he takes away: "In the end, it's all study, sacrifice, and determining that this will be the objective of your professional and personal life. Because for me, medicine is not just a form of work, but a form of being in life. That is, the doctor for me has to be 24/7 all year, and you have to live as a doctor." As the Hippocratic Oath states.

After graduation and studying for the MIR exam ( Medical Residency Exam ) , he succeeded. He became a licensed doctor and began the next section of his marathon: specialization in surgery, which was another five years. For this, he uses four words to describe this section: effort, study, sacrifice, and dedication. Always living medicine as a priority.

And now, his vision has not changed. After 30 years being a doctor, he still lives it with the same enthusiasm. "I think one of the keys has been wanting to always be doing new things to help people, which has kept me on this line."

A very long process which never ends, but one that has always been exciting, that has never lost its enthusiasm. Because in the end, you always have training as a doctor, training as a surgeon, and you are capable of helping people. There will always be someone you can help, regardless of whether you are head of service or a surgeon within a team. "In the end, the last resort or the last action we always have is to attend to a person. And that person will always exist, and attending to a person will always end up filling you professionally."

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Entering the Operating Room

I was intrigued. As someone who wants to walk his path, I asked how he felt when he enters the operating room and has the patient in front of him, someone who is giving their life and trust to his hands.

He begins by speaking of the immense responsibility that the operation deserves. In his first intervention, an acute appendicitis on April 23, 1995, after four months as a resident, he felt tremendous responsibility. Responsibility is the first word. It is a person who needs help, and that help will be derived from what he executes with his hands, directed by his brain.

After responsibility comes pride—the pride of being able to cure with your hands.

Here he makes a pause and speaks about how if any minor issue arises after the operation, it is his responsibility. That's why the dynamic always exists: responsibility, pride, pride, responsibility. This is what marks him professionally.

He then gives us a clearer image of the responsibility of curing through a comparison. His wife, an excellent endocrinologist specializing in type 1 diabetes, has the knowledge to help patients endure their condition and help them live longer with the disease. With her medical art, she maintains them well, but without the ability to cure it definitively. It has infinite value that she can help a person with a disease that can limit their quality of life to live normally.

Surgeons, on the other hand, can cure. He references the book and film "The Physician," where acute appendicitis (called "colic miserere" in the Middle Ages) used to kill people. Today, fortunately, it doesn't. With four months of experience as a resident, he was capable of solving a problem like that for life.

Of course, this ability is not without caution. Being a surgeon does not place you above any other person, and your coat should not float through the hospital. Yes, with four months in residency he was able to do a procedure which a couple of decades ago would have caused the death of the patient. But by no means is it a reason to lose your humility.

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Lesson

Speaking with Dr. César Ramírez made it clear that medicine is really about the people. Behind every diagnosis, every surgery, there is a human story — and maintaining that connection allows us to practice medicine that genuinely heals lives.

This section captures only part of our conversation, but it reflects a truth he embodies: the balance between pride and responsibility, between skill and humility. The path is long, walked step by step with sacrifice and dedication, but also with unwavering enthusiasm for the privilege of helping others. As you continue reading the next sections of this interview, I hope you feel as inspired as I did to explore medicine as a way of living, not merely a profession.

For the next sections of the interview, we will talk about creativity in medicine and reflections on knowledge he has acquired throughout his career.

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Interview Videos — All Sections & Full Conversation

Part I: The Calling: Childhood Memories and Medical Humanism

Part II: The Path: Marathon to the Operating Room

Part III: The Craft: Creativity Where Resources End

Part IV: The Lesson: Better Surgeon, Better Person

Complete Interview: The Humanist Surgeon — Dr. César Ramírez